@article{MTMT:1118079, title = {Fat necrosis after partial-breast irradiation with brachytherapy or electron irradiation versus standard whole-breast radiotherapy--4-year results of a randomized trial.}, url = {https://m2.mtmt.hu/api/publication/1118079}, author = {Lovey, K and Fodor, János and Major, Tibor and Szabo, E and Orosz, Zsolt and Sulyok, Z and Jánváry, Zsolt Levente and Fröhlich, Georgina and Kásler, Miklós and Polgár, Csaba}, doi = {10.1016/j.ijrobp.2007.03.055}, journal-iso = {INT J RADIAT ONCOL}, journal = {INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS}, volume = {69}, unique-id = {1118079}, issn = {0360-3016}, abstract = {PURPOSE: To examine the incidence and clinical relevance of fat necrosis after accelerated partial-breast irradiation (PBI) using interstitial high-dose-rate brachytherapy (HDR-BT) in comparison with partial-breast electron irradiation (ELE) and whole-breast irradiation (WBI). METHODS AND MATERIALS: Between 1998 and 2004, 258 early-stage breast cancer patients were randomized to receive 50 Gy WBI (n = 130) or PBI (n = 128). The latter consisted of either 7 x 5.2 Gy HDR-BT (n = 88) or 50 Gy ELE (n = 40). The incidence of fat necrosis, its impact on cosmetic outcome, accompanying radiologic features, and clinical symptoms were evaluated. RESULTS: The 4-year actuarial rate of fat necrosis was 31.1% for all patients, and 31.9%, 36.5%, and 17.7% after WBI, HDR-BT and ELE, respectively (p(WBI/HDR-BT) = 0.26; p(WBI/ELE) = 0.11; p(ELE/HDR-BT) = 0.025). The respective rate of asymptomatic fat necrosis was 20.2%, 25.3%, and 10% of patients. The incidence of symptomatic fat necrosis was not significantly different after WBI (8.5%), HDR-BT (11.4%), and ELE (7.5%). Symptomatic fat necrosis was significantly associated with a worse cosmetic outcome, whereas asymptomatic fat necrosis was not. Fat necrosis was detectable with mammography and/or ultrasound in each case. Additional imaging examinations were required in 21% of cases and aspiration cytology in 42%. CONCLUSIONS: Asymptomatic fat necrosis is a common adverse event of breast-conserving therapy, having no significant clinical relevance in the majority of the cases. The incidence of both symptomatic and asymptomatic fat necrosis is similar after conventional WBI and accelerated partial-breast HDR-BT.}, keywords = {Follow-Up Studies; Aged; Adult; Female; Middle Aged; Humans; Aged, 80 and over; Incidence; Radiotherapy Dosage; Breast Neoplasms/*radiotherapy; Fat Necrosis/*epidemiology/etiology/radiography; Electrons/adverse effects/therapeutic use; Breast/*pathology/radiation effects; Brachytherapy/adverse effects/methods}, year = {2007}, eissn = {1879-355X}, pages = {724-731}, orcid-numbers = {Major, Tibor/0000-0002-4672-6910; Jánváry, Zsolt Levente/0000-0002-4583-4901; Fröhlich, Georgina/0000-0001-6428-6536; Kásler, Miklós/0000-0002-7235-8787; Polgár, Csaba/0000-0001-7245-0762} }